目的：探讨子宫弓状动脉血流参数值在经腹超声诊断前置胎盘合并植入中的价值。方法：遴选2016年1月—2017年1月在郑州大学第三附属医院进行检查的晚孕期前置胎盘孕妇64例，行前瞻性经腹超声检查，记录胎盘后子宫弓状动脉的收缩期峰值流速（PSV）、阻力指数（RI）、搏动指数（PI），追踪手术结果，将入选病例分为非植入组和植入组，进行统计学分析并确定最佳诊断界点。结果：植入组较非植入组子宫弓状动脉PSV升高（P＜0.001），RI降低（P=0.01），PI降低（P=0.03），差异均具有统计学意义（P＜0.05）。子宫弓状动脉PSV的诊断准确性较高，最佳诊断界点为39.33 cm/s；RI、PI的诊断准确性中等，最佳诊断界点分别为0.385、0.51。结论：超声测量子宫弓状动脉血流参数值对前置胎盘合并植入具有明确价值。
Abstract
Objective: To evaluate the potential value of uterine arcuate artery blood-flow parameters in diagnosing placenta previa complicated with placenta accreta. Methods: 64 pregnant women in the third trimester with placenta previa who underwent ultrasound examination in the Third Affiliated Hospital of Zhengzhou University from January 2016 to January 2017 were adopted. All cases underwent uterine arcuate artery Doppler velocimetry to measure the peak systolic maximum velocity(PSV), resistance index(RI) and pulsatility index(PI). The patients were divided into two groups according to the operation results. Statistical analysis of PSV, RI and PI were performed to confirm the optimum boundary points of the indices. Results: The PSV of uterine arcuate artery was higher(P＜0.001) while RI and PI was lower(P=0.01, P=0.03) in the placenta accreta group compared to previa alone. The difference was statistically significant(P＜0.05). The diagnostic accuracy of PSV of uterine arcuate artery was high while RI and PI was moderate and the optimum boundary points was 39.33 cm/s, 0.385 and 0.51. Conclusion: The PSV, RI, PI of the uterine arcuate artery is of definite value in the diagnosis of placenta previa complicated with placenta accreta.
关键词
胎盘 /
前置 /
胎盘 /
侵入性 /
超声检查 /
多普勒 /
彩色
Key words
Placenta praevia /
Placenta accreta /
Ultrasonography, Doppler, color
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参考文献
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基金
河南省医学科技攻关计划项目（编号201503107、201702098）。
